Provider Demographics
NPI:1457374555
Name:SYME, WILLIAM CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHARLES
Last Name:SYME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26028
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6028
Mailing Address - Country:US
Mailing Address - Phone:505-262-7215
Mailing Address - Fax:505-232-1627
Practice Address - Street 1:5150 JOURNAL CENTER BLVD NE FL 2
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5900
Practice Address - Country:US
Practice Address - Phone:505-232-1572
Practice Address - Fax:505-232-3296
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM89311208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM3673Medicaid
NM3673Medicaid